Sustained DMARD-free remission in subgroups of patients with rheumatoid arthritis: an analysis of two prospective cohorts with early arthritis
Authors' conclusion
For the subgroup of patients with rheumatoid arthritis who require biological DMARDs, sustained DMARD-free remission does not seem attainable. In contrast, in patients with rheumatoid arthritis who do not require biological DMARDs, DMARD-free remission is attainable.
Study context
- Population
- Patients with early RA in the Leiden Early Arthritis Clinic (EAC) and the Rotterdam Early Arthritis Cohort (tREACH)EAC 627
- Participants
- 89 / 538 / 154 / 271
- Exposure
- Patients who ever used a bDMARD vs patients who never used a bDMARD
- EAC: ever used a biological DMARDn = 89
- EAC: never used a biological DMARDn = 538reference
- tREACH: ever used a biological DMARDn = 154
- tREACH: never used a biological DMARDn = 271reference
- Outcome
- Sustained DMARD-free remission: absence of clinical synovitis after discontinuation of disease-modifying antirheumatic drugs (DMARDs) for at least 1 year
- Follow-up
- 5 years (EAC); 3 years (tREACH)
Methodological detailstwo prospective early arthritis cohorts (Leiden EAC and tREACH), tREACH: treat-to-target steered trial, Kaplan-Meier curves, Patient partners were involved in the design of both the EAC and tREACH
- Two prospective early arthritis cohorts (Leiden EAC and tREACH)
- tREACH: treat-to-target steered trial
- Kaplan-Meier curves
- Patient partners were involved in the design of both the EAC and tREACH
Main finding
As reported in the abstract
HR for reaching sustained DMARD-free remission
0.02
95% CI 0.00–0.10P < 0.0001
EAC: ever used a biological DMARD vs EAC: never used a biological DMARD · at 5 years
HR for reaching sustained DMARD-free remission
0.03
95% CI 0.00–0.21P < 0.0001
tREACH: ever used a biological DMARD vs tREACH: never used a biological DMARD · at 3 years
Observational data: associations, not effects.
Original publication
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